when gaming, whether they’re novices or experts.27 (And who hasn’t lost track of time while on the computer?) Other research suggests decision making is impacted. In 2009, researchers concluded from a series of studies that players exhibited increased risk taking after playing an auto racing game — the so-called Racing-Game Effect.28 This finding lends credence to the concern that gaming can precipitate reckless behavior by glorifying and rewarding risk taking.
As I’ve mentioned, a growing body of research implicates the use of screen devices at night as a negative influence on daytime functioning, cognitive ability, and memory performance.29 Studies also show that light-at-night causes higher nighttime core temperature and heart rate and lower melatonin levels,30 markers associated with poor sleep and high stress. Lastly, numerous studies on multitasking — think Skyping and texting while doing homework — show it reduces efficiency and worsens performance.31 One 2013 study found that students who checked Facebook just once while studying tended to have lower GPAs.32
One of the most compelling studies to date has come out of Denison University, where researchers demonstrated that video game ownership can interfere with reading and writing skills in boys.33 Here, in a move that effectively eliminated any self-selection bias, researchers randomly split sixty-four boys ages six to nine who had never owned a video game into two groups. The children and families in the study were told only that they were receiving a reward for their participation — a video game console. One group received the console at the beginning of the four-month trial, while the control group received it at completion. The two groups were then compared in terms of academic achievement and behavior. The results showed that the boys receiving the console at the beginning of the study tested lower in reading and writing assessments, had more teacher-reported learning problems, and spent less time doing homework. Similarly, a 2010 study examined data collected on 150,000 middle school students in North Carolina and found that introducing a home computer had a negative and persistent impact on reading and math scores.34 The same conclusion was found by another 2010 study on low-income Romanian students, which compared the grades of those who had acquired a new home computer via a government-sponsored voucher program and those who had not.35
Likewise, various experts have made disturbing observations regarding technology’s effect on reading and learning. Dr. Leonard Sax, author of Boys Adrift, notes that in comparison to girls, boys are “falling off the curve” in terms of academic achievement and that the “gap” between boys’ and girls’ reading ability is growing; he cites video games as the second of five major contributors.36 Nicholas Carr, author of the critically acclaimed The Shallows, contends that the Internet is changing the depth of our reading and thinking. Carr writes, “The kind of deep reading that a sequence of printed pages promotes is valuable not just for the knowledge we acquire from the author’s words but for the intellectual vibrations those words set off in our own minds. In the quiet spaces opened up by the sustained, undistracted reading of a book … we foster our own ideas.”37 How can one reflect on or make new associations from written material at the same time one is skimming large amounts of information from the Internet — or having to process excess stimulation, for that matter?
In short, it is not an exaggeration to say that technology is “dumbing us down.” Screen-time makes us less attentive and less able to learn, remember, and think for ourselves.
Cole: Making the Grade
Cole, a young adult patient of mine with learning disabilities and ADHD, provides a dramatic example of screen-time’s effect on attention and learning. When he first came to see me, Cole declared that he wished to work on his reading skills and had recently taken placement tests at a local college. Academically, Cole had tested at a fifth-grade level in both reading and math. Fifth grade, interestingly enough, was the same year his teachers had introduced him to a computerized reading program. “They were all excited about it,” he said, “but then they gave up on me when it didn’t work.” In light of these goals, and because his mood and sleep patterns were dysregulated, I asked Cole if he was willing to give up a handheld video game of his that had practically become a new appendage. After a forty-minute discussion, Cole decided to leave the game in my office. A few days later, Cole’s brother left a voicemail stating that Cole’s mood had evened out almost immediately. Shortly after this (and much to my delight), Cole’s game console at home broke — he was now video game–free. A couple of months later, he was retested at the college for placement.
The results were nothing less than shocking: in math, which he’d always claimed he was good at, Cole now tested at a high school level, and his reading score had climbed four grade levels. I wouldn’t have believed him if he hadn’t shown me the actual testing results. Clearly, screen devices had been hindering this young man for many years, and his brain was now functioning at a level much more representative of his true capacity — making his literacy goals much more achievable. Indeed, as I’ll cover in chapter 11, research shows that screen-time use in general makes literacy achievement more difficult and that reading from a screen hinders reading comprehension.
Green-Time and Attention Restoration: A Cure for Aggression?
Appreciating the link between attention fatigue and tantrums, meltdowns, and more serious aggression is key to putting a stop to this type of unwanted behavior. Children with attention difficulties are at much higher risk for aggressive acts38 — not surprising considering inattention is associated with low frustration tolerance and an inability to check impulses. Meanwhile, restoring a child’s mental capacity for focus reduces risk. Attention restoration theory posits that while stress depletes attention, sensory input or stimulation that lowers the stress response (“easy attention”) restores the ability to focus.39 Studies show green environments reduce aggressive acts and improve attention, impulse control, and academic performance.40 Greenery draws the eye but lowers heart rate and blood pressure, thereby restoring focus and our ability to tolerate stress. Even pictures of greenery and viewing nature out of a window help, but time spent outdoors in nature is most powerful. Thus, in addition to the numerous ways screen-time contributes to aggression via hyperarousal, the fact that time spent indoors reduces exposure to the restorative effects of “green-time” is equally important!
Psychosis
Perhaps the most frightening repercussion of electronic devices is the emergence of psychosis, in which there are abnormal thoughts or thought processes. This can take the form of hallucinations (hearing voices or seeing things that aren’t there), delusions, paranoia, or confused thinking. In the cases I’ve witnessed, psychosis triggered by screen-time has occurred in individuals with underlying vulnerabilities, such as intellectual delays, a mood disorder, autism, or a history of neglect or severe abuse, especially sexual abuse. The vast majority of the time, the psychosis resolves or dramatically diminishes with the electronic fast. Often, in contrast to an individual with an “organic” psychosis, the person often knows what he or she is experiencing is imagined: the voices are heard but don’t feel “real,” the sense that others are talking about them doesn’t jive with reality, the nagging fear that someone is outside the window watching them at night seems silly during the day. Treating these cases can be very rewarding, because in addition to relieving symptoms, antipsychotic medicines can often be avoided, or if they’ve already been started, they can be reduced or even discontinued. This can lead to other pleasant by-products like weight loss and other health improvements.* Additionally, when a person’s psychosis resolves, he or she may suddenly become capable of attending school, holding down a job, or engaging in a romantic relationship.
On the other hand, if an individual is genetically predisposed to psychotic illness, such as schizophrenia or severe bipolar disorder, screen-time may represent the proverbial straw that breaks the camel’s back. It can trigger a “first break” — the initial episode in which an individual experiences a break from reality. In one sad
